An inguinal hernia is an abnormal bulge, or protrusion, that can be seen and felt in the groin area (the area between the abdomen and the thigh). An inguinal hernia develops when a portion of the intestine, along with fluid, bulges through the muscle of the abdominal wall.
Inguinal hernias in children result from a weakness in the abdominal wall that is present at birth. The bulge in the groin may only be noticed when the child is crying, coughing, or straining during a bowel movement, or it may appear to be larger during these times. Of the newborns who have inguinal hernias, 90 percent are boys.
What is an incarcerated hernia?
If the weakness or defect in the abdominal wall is small to moderate in size, a portion of intestine may get trapped, or incarcerated. This is called an incarcerated hernia and can cause problems such as sever pain, nausea, vomiting or absence of bowel movements. Larger abdominal wall defects allow the intestine to move freely in and out of the weakened abdominal wall and do not tend to be as painful.
What is a strangulated hernia?
If the intestine becomes incarcerated or trapped in the abdominal wall defect, blood flow may become blocked to the intestines. This is called a strangulated hernia. This type of hernia is often painful and requires prompt surgery.
How can a hernia be repaired?
Hernias usually need to be surgically repaired to prevent intestinal damage and further complications. The surgery takes about an hour and is usually an outpatient procedure (which means the patient can go home the same day of the procedure).
Dietary guidelines before surgery
Strict guidelines are enforced regarding the child’s diet the morning of the surgery. These guidelines will help reduce the risk of vomiting and aspiration (inhaling fluids) while your child is under anesthesia.
Your child can have his or her regular diet up to 8 hours before surgery, milk or ice cream up to 6 hours before surgery, and clear liquids (water, apple juice, gelatin, broth, etc.) up to 3 hours before surgery. After that time, your child should not eat or drink anything else until after the surgery.
During the surgery
- An anesthesiologist (a doctor who specializes in sedation and pain relief) gives your child general anesthesia, which relaxes your child’s muscles and induces sleep. Your child will not feel pain during the surgery.
- A small incision or cut (from 2 to 3 cm) is made in the skin fold of the groin.
- The hernia “sac” containing the bulging intestine is identified.
- The surgeon pushes the intestine inside the hernia sac back into its proper position behind the muscle wall.
- The hernia sac is removed.
- The muscle wall is reinforced with multiple layers of stitches to prevent another hernia.
- If your child is younger than 1 year of age, the chance that a hernia will develop on the other side of the groin is very high. Repair of both inguinal areas is, therefore, recommended. If there is not presently a hernia on the other side of the groin area, the muscle wall is reinforced with stitches.
After the surgery
Most children will be able to go home a few hours after surgery. However, premature infants and children with certain medical conditions may need to spend one night in the hospital for observation.
Caring for your child after surgery
Usually, your child will feel fine again the evening after surgery or by the next morning. As soon as your child is able, he or she can resume normal eating habits and activities.
You may give your child a sponge bath the day after surgery. Tub baths are permitted 2 days after surgery.
The small piece of tape covering your child’s incisions (called a steri-strip) will gradually fall off on its own. Do not pull this strip off yourself. If the strips do not fall off on its own, your health care provider will remove it at your child’s follow-up appointment.
When to call your child’s health care provider
You may notice some minor swelling around the incision or scrotal sac. This is normal. However, call your health care provider if your child is unable to urinate, or has:
- A fever
- Excessive swelling
- Increasing pain.
A follow-up appointment will be scheduled from 7 to 10 days after your child’s surgery. Your health care provider will assess your child’s wound sites and his or her recovery during this visit.Leave a reply